三种营养筛查工具对维持性血液透析病人透析相关性蛋白质-能量消耗的评价比较

发布时间：2018-03-21 12:44

本文选题：蛋白质-能量消耗　切入点：血液透析　出处：《肠外与肠内营养》2017年03期 　论文类型：期刊论文

【摘要】：目的:比较三种营养筛查工具对血液透析病人透析相关性蛋白质-能量消耗(PEW)的预测作用,以筛选出一种快速、准确和易行的方法。方法:采用营养风险筛查2002(NRS 2002)、7分主观整体评估(7分SGA)、营养不良炎症评分(MIS)三种筛查工具对205例行维持性血液透析病人进行PEW患病率调查。同时,将三种筛查工具与人体测量指标、血生化指标等进行相关性分析,并与国际肾脏营养与代谢学会(ISRNM)制订的PEW诊断金标准进行比较。结果:根据ISRNM标准,31.2%的透析病人存在PEW,基于MIS、7分SGA、NRS 2002的评价标准,透析病人PEW的患病率分别为58.0%、40.8%和46.8%。三种筛查工具均与血生化和人体测量学指标呈明显相关关系(P0.05),其中NRS 2002与常用客观营养指标的复合相关系数最大(r=0.787,P0.001),相关性最为密切。在透析病人中,NRS 2002有较高的灵敏度和正确指数,分别为87.5%和59.1%。结论:对透析病人,MIS、7分SGA、NRS 2002三种筛查工具均有较好的准确性,以NRS 2002更优。NRS 2002可能是预测透析病人PEW更快速、准确、易行的营养筛查工具。
[Abstract]:Objective: to compare the predictive effects of three nutritional screening tools on dialysis associated protein-energy expenditure (PEW) in hemodialysis patients in order to screen out a rapid one. Methods: to investigate the prevalence of PEW in 205 patients with maintenance hemodialysis by using three screening tools: nutritional risk screening (NRS 2002) and subjective global assessment (SGAA, 7). The correlation between the three screening tools and anthropometric indicators, blood biochemical indicators, etc. Results: according to the standard of ISRNM, 31. 2% of dialysis patients had PEW, based on the criteria of MIS7 and SGAN RS 2002, and compared with the standard of PEW diagnostic gold developed by the International Society of Renal Nutrition and Metabolism (ISRNM), results: according to the standard of ISRNM, 31. 2% of dialysis patients had PEW. The prevalence rate of PEW in dialysis patients was 40.8% and 46.8%, respectively. There was a significant correlation between the three screening tools and blood biochemical and anthropometric indexes (P 0.05). The maximum correlation coefficient between NRS 2002 and common objective nutritional indicators was 0.787g / P0.001. NRS 2002 has high sensitivity and correct index in dialysis patients. Conclusion: the three screening tools for dialysis patients were better accuracy. NRS 2002 is better. NRS2002 may be a more rapid, accurate and easy nutritional screening tool to predict PEW in dialysis patients.
【作者单位】：中山大学公共卫生学院营养系;广州市红十字会医院临床病态营养研究所;番禺中心医院血液净化中心;
【基金】：广东省重点基地建设项目(2014B030303002) 广州市科技惠民专项(14A33151295)
【分类号】：R459.3;R692.5

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